Quality Management Specialist - LHB in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Quality Management Specialist - LHB in the United States.

This role plays a key part in ensuring high standards of quality, compliance, and regulatory excellence within healthcare management operations. You will coordinate and implement quality improvement initiatives while supporting adherence to state, federal, and accreditation requirements. Acting as both a subject matter resource and a cross-functional collaborator, you will help drive audits, performance monitoring, and continuous improvement efforts. The position requires strong clinical expertise combined with analytical and regulatory knowledge to identify risks, evaluate processes, and recommend improvements. You will also contribute to education and alignment across teams to ensure consistent, high-quality care management practices. This is a remote opportunity within a structured, mission-driven healthcare environment where your work directly supports patient outcomes and organizational compliance.

• Coordinate and implement quality improvement initiatives across healthcare management operations, ensuring alignment with regulatory, accreditation, and internal standards.
• Monitor performance metrics, conduct audits, and support root cause analyses to identify trends, risks, and improvement opportunities.
• Ensure compliance with applicable state, federal, and accreditation requirements, including licensure, policy development, and regulatory standards.
• Lead and support quality committees, contributing to governance activities and documentation of outcomes and recommendations.
• Serve as a quality and compliance resource across teams, providing education, guidance, and support on best practices and regulatory expectations.
• Collaborate with cross-functional stakeholders to promote consistent processes and high-quality care management delivery.
• Support customer satisfaction tracking and improvement initiatives through data analysis and process evaluation.
• Develop reports, correspondence, and documentation related to quality management activities and findings.

• Active, unrestricted Registered Nurse (RN) license issued in a U.S. state or territory.
• Minimum of 3 years of clinical experience in areas such as medical-surgical nursing, community health, or home health.
• Strong understanding of healthcare operations, clinical processes, and care management environments.
• Ability to interpret policies, procedures, regulatory documents, and clinical criteria accurately.
• Experience analyzing data, identifying trends, and applying problem-solving techniques to quality issues.
• Strong written and verbal communication skills, with the ability to interact effectively with patients, providers, and leadership.
• Ability to work independently while managing multiple priorities in a fast-paced, structured environment.
• Strong organizational skills and attention to detail, with the ability to manage time-sensitive assignments.
• Preferred: prior quality management experience in managed care settings.
• Preferred: familiarity with URAC or NCQA accreditation standards.
• Preferred: Bachelor of Science in Nursing (BSN).

• Competitive salary range of $57,800 to $108,500 annually, based on experience, skills, and location.
• Eligibility for annual incentive bonus program.
• Comprehensive benefits package including medical, dental, and vision coverage.
• Retirement savings options including 401(k) and pension plan.
• Paid time off, paid holidays, and paid parental leave.
• Tuition reimbursement and professional development support.
• Employee assistance programs and supplemental insurance options.
• Strong focus on work-life balance with a fully remote work arrangement (eligible U.S. states only).